| Japanese |
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| Title | 喘息発作中に発生した冠攣縮 |
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| Subtitle | 症例 |
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| Authors | 日野博文, 佐々木英輝, 佐々木千晶, 磯村朗子, 本多泰子, 舘田武志, 山中郁男 |
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| Organization | 聖マリアンナ医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 23 |
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| Number | 3 |
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| Page | 313-315 |
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| Year/Month | 2002/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | はじめに 気管支喘息, 冠攣縮はともに平滑筋の攣縮を主病態とする疾患および症候であり, これらを同時に生じた報告も散見される1,2）. 両者の発症機序や背景には共通点も多く, 平滑筋における全身性反応性亢進の一部をとらえている可能性もある. 今回, 抜管直後の喘息発作中に発生した冠攣縮を経験したので報告する. 症例 86歳女性. 身長140cm, 体重42kg. 1年3ヶ月前に子宮頸癌の診断にて化学療法（ネダプラチン100mg, 硫酸ペプロマイシン15mg, マイトマイシンC6mg）施行後, 準広汎子宮全摘術目的にて入院となった. 既往歴として, 喘息があり, 初回の化学療法施行後に発作を起こし, アミノフィリン, ヒドロコルチゾンの点滴静注, 硫酸サルブタモール 200μg, クロモグリク酸ナトリウム2mgの吸入にて軽快した既往がある. 家族歴は問題なし. 術前検査にてHb 9.3g/dlと貧血, BUN 22.5mg/dl, クレアチニン1.2mg/dlと腎機能障害を認めた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Coronary spasm, Asthma attack |
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| English |
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| Title | A Case of Coronary Arterial Spasm During Asthma Attack |
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| Authors | Hirofumi Hino, Eiki Sasaki, Chiaki Sasaki, Akiko Isomura, Yasuko Honda, Takeshi Tateda, Ikuo Yamanaka |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, St. Marianna Univ. School of Medicine |
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| Journal | Circulation Control |
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| Volume | 23 |
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| Number | 3 |
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| Page | 313-315 |
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| Year/Month | 2002/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | This case reports an occurrence of coronary arterial spasm during asthma attack. An 82-year old female with a history of asthma attack was scheduled for total hysterectomy and lymphadenectomy. Anesthesia was maintained with nitrous oxide in oxygen, sevoflurane and epidural anesthesia. The intraoperative surgical and anesthetic courses were uneventful. An asthma attack occurred after the extubation, so bronchodilation therapy was started, including the administration of aminophylline. After administration of aminophylline, the ST segment of ECG was suddenly elevated on ECG accompanied with an increase in blood pressure and heart rate. The administration of isosorbide and nicorandil effectively returned ST elevation to normal. Postanesthetic examination revealed no abnormality on coronary angiography, and hypereosinophillia. The administration of bronchodilator affects not only cardiac function and also the autonomic system. It should be required consideration when using a bronchodilator, because asthma patients and coronary spasm patients might share some common characteristics. |
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| Practice | Basic medicine |
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| Keywords | Coronary spasm, Asthma attack |
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